Associate Iii

3 weeks ago

Chennai, India UST Full time

**Certified Medical Coder I**

**SUMMARY**:
Certified MRA Coder I, will perform Retrospective Review to assist healthcare providers in identifying and resolving issues related to incomplete or missing clinical documentation. Increase accuracy, completeness and compliance with clinical condition documentation to enable providers to deliver quality of care.

RESPONSIBILITIES/TASKS:

- Ensures compliance with all applicable Federal, laws and regulations related to coding and documentation guidelines for Commercial and Medicare Risk Adjustment Payment System.
- Performs remote medical record review to capture of all relevant diagnosis codes included in the CMS and HHS Hierarchical Condition Categories (HCC) conditions for Commercial and Medicare Risk Adjustment Payment system.
- Focus on retrospective coding to close HCC gaps and add HCC codes not reported. Ensure diagnosis codes are supported by the documentation and ensure adherence with ICD-10CM Guidelines for Coding and Reporting.

EMPLOYMENT QUALIFICATIONS: EDUCATION:
High School degree or equivalent required. Bachelor’s degree in a related field preferred. Successful completion of a coding license or certificates; CPC, CRC, CPMA, or CCS-P. Continuous learning, as defined by the Company’s learning philosophy, is required. Certification or progress toward certification is highly preferred and encouraged.

EXPERIENCE:
One (1) year HCC coding experience. Experience and understanding of CMS HCC Risk Adjustment coding and data validation requirements. Successful completion of a coding certificate program. CPC, CRC, or CPMA from AAPC, or CCS-P f rom AHIMA. Initial demonstration and maintenance of continuing education/membership is required.

SKILLS/KNOWLEDGE/ABILITIES (SKA) REQUIRED:

- Excellent organization and problem-solving skills.
- Strong oral and written communication skills.
- Advanced understanding of medicalterminology, pharmacology, body systems/anatomy, physiology, and concepts of disease processes.
- Extensive knowledge of and ICD-10CM coding guidelines and AHA CodingClinic.
- Advanced technical skills for use of MS Office (Excel, Word, Outlook, and PowerPoint) as demonstrated through successful completion of a skills test.
- Demonstrated ability to utilize a variety of electronic medicalrecords systems.
- Ability to manage a significant work load, and to work efficiently under pressure, while meeting established deadlines with mínimal supervision.
- Demonstrated ability to communicate clearly and effectively with a wide varietyof individuals at all levels of the organization. Strong time managementskills.
- Must possess a high degree of accuracy,efficiency, and dependability.
- Excellent written and oral communication for representation of clear and concise results.

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